Provider Demographics
NPI:1609864925
Name:PARRA-DAVILA, EDUARDO (MD)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:PARRA-DAVILA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CELEBRATION PL STE 302
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5435
Mailing Address - Country:US
Mailing Address - Phone:407-303-3824
Mailing Address - Fax:407-303-3825
Practice Address - Street 1:1309 N. FLAGLER DRIVE
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-5435
Practice Address - Country:US
Practice Address - Phone:561-882-4541
Practice Address - Fax:561-650-6093
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73141208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269027600Medicaid
FL37324Medicare PIN
FL269027600Medicaid